Individual
DR. THEODORE COUTSOFTIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4061 MORNING STAR DR, HUNTINGTON BEACH, CA 92649-3009
(714) 336-7949
(714) 840-6314
Mailing address
4061 MORNING STAR DR, HUNTINGTON BEACH, CA 92649-3009
(714) 336-7949
(714) 840-6314
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
A031348
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020038943
RAILROAD MEDICARE
—
01
—
A031348
LICENCE
CA
Enumeration date
08/02/2007
Last updated
09/30/2019
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